Healthcare Provider Details

I. General information

NPI: 1366411985
Provider Name (Legal Business Name): SELECT PHYSICAL THERAPY OF COLORADO SPRINGS LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date: 11/20/2007
Reactivation Date: 01/04/2008

III. Provider practice location address

15 S WEBER ST SUITE A
COLORADO SPRINGS CO
80903-1902
US

IV. Provider business mailing address

4714 GETTYSBURG RD LEGAL DEPT
MECHANICSBURG PA
17055-4325
US

V. Phone/Fax

Practice location:
  • Phone: 719-630-7774
  • Fax:
Mailing address:
  • Phone: 717-972-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOHN F DUGGAN
Title or Position: VICE PRESIDENT
Credential:
Phone: 717-972-1100